Individual
DR. JOCELYN BLANDO VERGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10410 RIDGEFIELD PKWY, RICHMOND, VA 23233-3544
(804) 754-3776
(804) 754-0880
Mailing address
10410 RIDGEFIELD PKWY, RICHMOND, VA 23233-3544
(804) 754-3776
(804) 754-0880
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
0101049794
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101049794
LICENSE TO PRACTICE
VA
Enumeration date
06/20/2006
Last updated
03/07/2023
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